Who Is Not The Right Candidate For Liver Transplant Surgery?

The liver has a significant role to play in metabolism and digestion. The failure of a liver can lead to significant health issues. There are some causes for liver failure, which cannot be treated with medications. In these people, a transplant, which is replacing the diseased or injured liver with another liver, is the only definitive treatment option.

Some conditions which can require a liver transplant are:

• Severe cirrhosis with a life expectancy of less than a year
• Severe liver failure
• Non-alcoholic steatohepatitis (NASH)
• Liver cancer
• Chronic hepatitis C
• Biliary atresia in children

Types of transplant:

• Living donor transplant: In some patients, partial liver can be removed from a close family member and transplanted into the affected individual. The liver is known for its regeneration ability, and over time, will grow in the recipient.
• Cadaveric transplant: Immediately after death, a liver can be removed and transplanted.

While the concept of a transplant sounds quite convincing and appealing for those with a severe liver disease, it is also important to note that not all would qualify for a liver transplant. The conditions which would disqualify a recipient are discussed below:

• Significant heart disease: Those with severe coronary artery disease, valvular disease, cardiomyopathy, aortic stenosis, and cardiomyopathy are not candidates for a liver transplant.
• Severe lung disease: Those with poor lung perfusion do not qualify for a liver transplant.
• Advanced age: Greater the age, lesser the survival rates. So, people aged more than 70 are usually not considered for a transplant.
• Obesity: A person with a BMI of more than 35 is often not a good candidate for a transplant. The overall health should be managed in these people.
• Malnutrition: On the other extreme, severely malnourished individuals are also not considered for a transplant.
• HIV infection: A person who is HIV-infected does not qualify for a liver transplant.
• Substance abuse: Anyone who is actively abusing alcohol and/or substances is definitely removed from the list for a transplant.
• Metastasis: If a patient is looking for a liver transplant due to hepatic cancer, it is essential that the cancer is contained. If it has spread to various parts, then containing it would be difficult, and a transplant may not succeed.
• Multisystem organ failure: Other than heart and lungs, even people with poor renal function are not ideal candidates for a liver transplant.

A detailed liver recipient evaluation assessing the severity of liver disease, chances of survival, and overall health are done before a person is listed for liver transplant. This evaluation ensures a better success rate with the transplant.